Cancer  25 Years Later

by Neil Fiore, PhD, 30-year survivor of a "terminal" cancer diagnosis

When the first edition of
my book Coping with the
Emotional Impact of Cancer:
Become an Active Patient and Take
Charge of Your Treatment was published
in1984, the stigma associated with the
word cancer was so strong that I had to
fight to get the word cancer included in
the title. Twenty-five years ago, it was
considered controversial for patients to
actively participate in their medical treatment.
And a battle of correspondence
ensued in The New England Journal of
Medicine when I and others suggested
that you might improve the quality of
your life – and possibly your chances
of survival – by learning how to cope
with the stress and emotional impact
of cancer.

Twenty-five years ago when a person
passed away from cancer, the newspapers
stated that they had “died of a long
illness.” Seldom was the word cancer
used in the press, except as a metaphor
for something dreadful that was “spreading
like a cancer.”

Now, 25 years later, daily newspapers,
television shows, and magazines such as
Coping® candidly bring us news about
new cancer treatments, offer ways that
people with cancer and their families
can cope with the disease, and share the
stories of well-known people living and
thriving in spite of cancer. Much of the
credit for this change in attitude and
for the lowering of the public’s fear of
talking openly about cancer belongs
to American women. For decades,
they lobbied for an alternative breast
cancer surgery that was less physically
and emotionally scarring than Dr. William
S. Halsted’s radical mastectomy
– first used in the 1890s and then remaining
the main treatment for breast
cancer until the 1970s.

Seldom was the word cancer used in the press, except as a metaphor
for something dreadful that was “spreading like a cancer.”

When research published in the
1980s finally proved that partial mastectomies
and lumpectomies – for early
stage and small tumors, usually followed
by radiation or chemotherapy – were as
effective as a radical mastectomy, women
persuaded their doctors to stop using the
Halsted radical mastectomy.

Prominent women in the media, politics,
and entertainment began to speak
openly about their cancer and gave us
evidence that it is possible to cope with
and survive cancer. Consider the names
of women who have openly coped with
a cancer diagnosis:
former first
lady Betty Ford,
Jane Brody of the
New York Times,
singer Sheryl
Crow, and news
anchor Robin
Roberts, who is
living proof that
it is possible to
work in television
– on Good Morning America, no less –
while bald from chemotherapy.

Those who have gone before us have
lessened the stigma associated with cancer
and have lowered our fear of making
an appointment to see a doctor, seeking
treatment, and hoping for a cure. And
today, we have good reason to be hopeful.
The National Cancer Institute’s 2007
report states that death rates for the four
most common cancers (prostate, breast,
lung, and colorectal), as well as for all
cancers combined, continue to decline.

Just take a look at the improvement
in survival rates. In the period between
1950 and 1954, the five-year survival
rate was just 35 percent. During the
period between 1999 and 2005, the fiveyear
survival rate rose to 66.1 percent!
Advances in early detection, improved
treatments – especially in chemotherapy
– and the public’s willingness to seek
information, change health habits, and
seek treatment earlier are factors that
have contributed to this vast improvement
in cancer survival rates:

Some of the biggest increases in survival
rates over the past 25 to 30 years
have been seen in childhood cancers
– from 58.1 percent in 1975-1977 to
81.3 percent in 1999-2005.

Prostate cancer, one of the most common
types of cancer for men, had a
five-year survival rate of 68.9 percent
in 1975 and improved to 99.2 percent
by 2000.

Survival rates for colon (or colorectal)
cancer have been steadily improving
for more than 30 years – in 1975, the
survival rate was 50.8 percent; in 2000,
the survival rate jumped to 66.8 percent.

Twenty-five years ago, the word cancer
was considered a death sentence, and
it carried with it a stigma. That’s not
true today. Twenty-five years later, we
all have a better chance of having cancer
detected earlier, of surviving longer, and
of being cured.

♦ ♦ ♦ ♦ ♦

Dr. Neil Fiore is a psychologist,
keynote speaker, and metastasized testicular
cancer survivor residing in Berkeley, CA. He
is the author of Coping with the Emotional
Impact of Cancer: Become an Active Patient
and Take Charge of Your Treatment (Bay-
Tree, 2009). For more articles and helpful
tips from Dr. Fiore, go to neilfiore.com.

This article was published in Coping® with Cancer magazine,
January/February
2010.